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이비인후과 진료에서 확증편향의 위험성: 수술 후 출혈로 오인된 후방 비출혈 증례
김순준,김재현,석상혁,이태훈 대한이비인후과학회 부산,울산,경남 지부회 2023 임상이비인후과 Vol.34 No.3
Confirmation bias is a cognitive bias in clinical practice where healthcare professionals tend to give more weight to data that support their initial diagnosis while ignoring evidence that contradicts it. This can lead to diagnostic errors and poor medical decision-making, ultimately resulting in adverse outcomes for patients. One potential complication following endoscopic sinus surgery is postoperative bleeding, which can occur immediately or as delayed bleeding several days after the procedure. While spontaneous epistaxis, or nosebleeds, are a common ENT emergency, posterior epistaxis is particularly challenging to detect and treat, which can result in significant bleeding. This report highlights a case in which posterior epistaxis was initially misdiagnosed as postoperative hemorrhage after endoscopic sinus surgery, leading to a delay in treatment. Such diagnostic errors can have severe consequences for patients, underscoring the importance of being vigilant for confirmation bias and its potential impact on clinical decision- making.
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턱관절의 활막 연골종증에 동반된 후천성 외이도 폐쇄증 1예
김순준,김재현,권중근 대한이비인후과학회 2022 대한이비인후과학회지 두경부외과학 Vol.65 No.6
Synovial chondromatosis (SC) is a rare disease involving long bones, rarely affecting the tem- poromandibular joint (TMJ). It can manifest as preauricular swelling, pain, and joint dysfunc- tion. This report represents the case of acquired atresia of external auditory canal in associa- tion with SC of TMJ. Active evaluation and treatment of TMJ pathology seem essential when addressing the acquired atresia of external auditory canal.
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소아에서 편도 및 아데노이드 절제술 후 식이 시작 시간과술후 합병증 발생 사이의 연관성에 관한 연구
김순준,남정권,김재현,강병철,이태훈 대한이비인후과학회 2024 대한이비인후과학회지 두경부외과학 Vol.67 No.2
Background and Objectives Tonsillectomy is one of the most common operative proce-dures performed in children by otolaryngologists. However, many surgeons demand excessivefasting from their patients for the fear of pulmonary aspiration and postoperative bleeding af-ter surgery. This study was performed to investigate the effect of early feeding after tonsillec-tomy on acute postoperative pain, vomiting and postoperative bleeding in children. Subjects and Method Data were collected via retrospective medical chart review. A totalof 121 patients under the age of 12, who underwent tonsillectomy along with adenoidectomyin our hospital, were included in this study. The patients were divided into two groups accord-ing to the time of first water or liquid intake and first diet, respectively. Operation time, anes-thesia time, state of appetite at the beginning of a soft diet, degree of postoperative pain, therequirement of intravenous analgesics and incidence of vomiting during hospitalization andincidence of postoperative bleeding were compared. Results There was no significant difference in the degree of pain, the requirement of intra-venous analgesics, the incidence of vomiting or postoperative bleeding according to the timeof first water or liquid intake. In addition, there was no difference in the degree of appetite andpain, the requirement of intravenous analgesics, incidence of vomiting or postoperative bleed-ing according to the time of first diet. Conclusion Initiating feeding as early as possible after tonsillectomy does not appear to in-crease acute postoperative pain, vomiting or postoperative bleeding.
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김순준,권중근 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.10
The majority of tympanoplasty procedures have been performed using the retroauricular ap-proach to improve visualisation of the anterior tympanic membrane. The classic retroauricularapproach requires elevation of the Körner flap and tympano-meatal flap through the ear canalskin incision. This step can lead to the exposure of the bones in the ear canal, resulting in de-layed wound healing and pain, especially in elderly or immunocompromised patients. Endo-scopic ear surgery is a minimally invasive procedure that offers a wider field of view, but hasthe disadvantage of being a one-handed operation and cannot avoid skin incisions in the earcanal for tympanoplasty. Here we present a hybrid retroauricular approach without skin inci-sion of the ear canal, using both microscope and endoscope. This method provides very fastwound healing and significantly less pain.
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비중격 미부 교정을 위한 부분 절단 봉합술의 장기적인 효과 분석
김태군,김순준,남정권,이태훈 대한이비인후과학회 부산,울산,경남 지부회 2021 임상이비인후과 Vol.32 No.1
Background and Objectives: Correcting the caudal septal deviation is one of the most difficult challenges of rhinologists. The purpose of this study is to evaluate the long-term effect of the partial cutting and suture technique for its correction. Materials and Methods: Korean version Nasal Obstructive Symptoms Evaluation (NOSE) scale score were compared and analyzed before surgery and three months and about two years after surgery in patients who underwent caudal septoplasty using the partial cutting and suture technique. Results: A total of 29 patients were included in this study. The average NOSE scale score before surgery was 43.97, which improved to 12.93 (p<0.001) at three months after surgery and finally 15.69 (p<0.001). The high dorsal deviation was observed in 75% in the non-improved group and 47.6% in the improved group. Conclusions: Correcting the caudal septal deviation through the partial cutting and suture technique showed excellent results in the long-term evaluation.
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김태군,권중근,강병철,김순준,김진일 대한이비인후과학회 2022 대한이비인후과학회지 두경부외과학 Vol.65 No.9
Background and Objectives Recently, myringoplasty, which does not require elevation oftympanomeatal flap, has drawn attention again as a minimally invasive surgery. This studyassessed clinical usefulness of simple underlay myringoplasty in repairing dry perforated eardrumor chronic suppurative otitis media in aged and/or frail patients. Subjects and Method This retrospective study included patients who underwent simpleunderlay myringoplasty from February 1, 2017 to September 30, 2020, and who were monitoredfor more than 6 months after surgery. Major outcome measurements were determinedby graft success and hearing results. Results A total of 106 cases were studied. The overall graft success rate was 84.0% and themean air-bone gap decreased by 7.8 dB postoperatively. The graft take was quite successfuleven in the cases of recurrent or chronic otorrhea in aged (≥70 years old) and/or frail patients. Conclusion Simple underlay myringoplasty could be used as a minimally invasive surgeryin dry perforated eardrum. It could be also considered as the first surgical choice for recurrentor chronic otorrhea in chronic suppurative otitis media in aged and/or frail patients.
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무선랜 환경에서 스트리밍 서비스의 QoE 향상을 위한 네트워크 인지형 망 이동 기법
김형준(Hyung-Jun Kim),주광성(Kwang-Sung Ju),김순준(Sun-Jun Kim),김영욱(Young-Wook Kim),이성희(Sung-Hee Lee),오승준(Seung-Jun Oh),정광수(Kwang-Su Jung) 한국정보과학회 2009 한국정보과학회 학술발표논문집 Vol.36 No.2D
최근 무선인터넷 서비스 수요의 증가에 따라 낮은 비용, 간편한 설치 그리고 높은 대역폭 특성을 가지는 무선랜 (Wireless LAN)을 기반으로한 사내 망 구성이 학교 및 기업을 중심으로 증가하고 있다. 또한 사내 망을 통하여 랩탑 (Laptop), 넷북 (Notebook), 그리고 UMPC (Ultra Mobile Personal Computer)등 휴대용 단말을 이용한 스트리밍 서비스의 수요가 증가하고 있다. 그러나 무선랜 환경에서는 스트리밍 서비스를 받는 사용자의 이동에 따른 스트리밍 서비스 품질 (QoE)을 고려하지 않는 문제점이 있다. 본 논문에서는 무선랜 환경에서 사용자가 핸드오버를 할 때 이동할 망의 상태를 인지하여 최적의 망을 선택함으로써 스트리밍 서비스 품질을 보장하는 기법을 제안 및 구현하였다. 제안하는 기법은 핸드오버 시 이동 할 대상망들의 신호세기와 가용대역폭을 인지하여 이동할 망을 선택함으로써 패킷 손실에 따른 스트리밍 품질의 열화를 방지한다.
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